Objective: To evaluate the changes of accommodative function after implantation of iris-fixated phakic intraocular lens (IFPIOL) for correction of high myopia, and compared with gender and age matched emmetropes. This study also provides clinical basis for assessing the quality of life after implantation of the IFPIOL.
Methods: It was a case-control study. Iris-fixated in phakic intraocular lens implantation was performed in 23 eyes of 12 high myopic patients. Control group included 22 eyes in 11 emmetropes. All patients and controlled subjects had the same examinations including amplitude of accommodation, accommodative facility test, and negative/positive relative accommodation before, 1 month and 3 months after operation. Surgery was performed by the same surgeon. Randomized block design analysis of variance was applied to analyze accommodative function between the patients preoperative and postoperative, and two independent samples t-test was applied to analyze accommodative function between the control group and the patients. P value less than 0.05 was considered significant.
Results: The mean amplitude of accommodation at 1 month and 3 months was (8.90 ± 2.13) D and (9.10 ± 1.72) D after IFPIOL implantation, respectively. Mean amplitude of accommodation after the operation was significantly greater than that from preoperative eyes (7.35 ± 2.20) D, (F = 19.88, P < 0.01). Mean amplitude of accommodation at 3 months in eyes after IFPIOL implantation showed no significant difference (t = -1.76, P = 0.09) as compared with the control group (10.10 ± 2.09) D. Mean accommodative facility at 1 month and 3 months after IFPIOL implantation was (8.17 ± 2.09) cyc/min and (8.67 ± 1.80) cyc/min, respectively. This was significantly increased from preoperative data which was (5.67 ± 1.53) cyc/min, (F = 64.27, P < 0.01). Mean accommodative facility at 3 months after IFPIOL implantation had no statistically significant difference (t = -6.29, P < 0.01) as compared with the control group (14.51 ± 3.81) cyc/min. In addition, mean positive relative accommodation (2.45 ± 0.81) D was significantly greater than that in preoperative eyes (1.61 ± 0.80) D, (F = 6.10, P = 0.01) but, not significantly different (t = -2.83, P = 0.01) from the control group (3.89 ± 1.49) D.
Conclusions: Patients can obtain physiological accommodative function after the implantation of IFPIOL for correction of high myopia. Moreover, the accommodative function increases with time and is stable. Nevertheless, accommodative function could not reach the level of normal emmetropic eyes. Longer-term results would be further observed.